Jayson:

Welcome to this week's episode of The Ankylosing Spondylitis Podcast. I'm very lucky today to have on Dr. David Fox. Dr. Fox is one of the co-chairs of the University of Michigan's Autoimmune Center of Excellence. Dr. Fox has been a rheumatologist for a number of years, a member of the medical school faculty since 1985, Dr. Foxx is a professor of Internal Medicine, and from 1990 to 2018 was the chief of the Division of Rheumatology with the University of Michigan's medical school. You've gotten your undergrad from Massachusetts Institute of Technology and your Doctorate from Harvard Medical School. So fantastic training as you then jumped up to University of Michigan, Where you work through all the different wonderful areas that the University of Michigan's medical school has to offer. So, Dr. Fox, glad to have you here and welcome.

Dr. Fox:

Jayson, thank you very much. I'm very pleased to be chatting with you this morning.

Jayson:

Something that I find very interesting that you’re involved in is this Autoimmunity Center of Excellence. As we discussed prior to the conversation, there's about 12 or 11 of those centers around the US at different universities and hospitals. And what is the basic premise of an Autoimmunity Center of Excellence?

Dr. Fox:

It's a group of investigators that are conducting research in the treatment of autoimmune diseases and also trying to understand causes of autoimmune diseases. And these include forms of arthritis, other rheumatologic diseases like Lupus and Scleroderma, and autoimmune diseases that are in other areas of medicine, like for instance, Multiple Sclerosis, which affects the brain. Different centers have specific projects and clinical trials that they're working on. But a very important part of this Autoimmunity Center of Excellence or Ace program, as it's called, is that the different centers have a chance to meet a few times a year and interact with each other and have what are called collaborative projects where we get to work together with an experts at other institutions and benefit from their knowledge and hopefully they benefit from ours.

Jayson:

Now what I find interesting and these Autoimmunity Centers of Excellence, the ones we're talking about that you're involved with are all in the United States. Is there cross-country collaboration, like do you as doctors and researchers work with folks say in England or Australia or Canada, anything of that nature?

Dr. Fox:

Yes, we do. Not necessarily directly within the framework of this Ace program, but in other aspects of our research. We certainly work with physicians in other countries. One way that that occurs is in some of the clinical trials, particularly in our scleroderma program. Many of these trials are international trials. It's a rare disease. So we may need quite a few centers to Join up in a clinical trial to recruit the number of patients needed for you know, useful study. So we have collaborations with our colleagues in Europe and in Canada and occasionally other parts of the world.

Jayson:

Interesting. Your background, I know you've really focused on Rheumatoid Arthritis and the Scleroderma. 

Dr. Fox:

Yes. 

Jayson:

When we look at those diseases, how do they cross over into fields of say, like research for Ankylosing Spondylitis? Or can something that happens in Rheumatoid Arthritis say; oh, wow, this may or may not work for AS let's try it on AS patients.

Dr. Fox:

Yes. So there are similarities and also differences between these various diseases and sometimes we find out more about where the similarities and differences are by trying new treatments and seeing what works. So for instance, if you look at TNF blockers, so these are biologics that inhibit the action of a molecule called TNF (tumor necrosis...